1National Institute of Pharmaceutical Education and Research, Pharmacy Practice, Punjab, India
Objective: To evaluate the efficacy and safety of brivaracetam (BRV) as an add-on therapy for people with drug-resistant epilepsy.

Methods: Comprehensive literature search was done in PubMed, Cochrane Library and other databases for clinical trials (CTs) investigating the efficacy of BRV in the treatment of drug resistant epilepsy. 5 CTs having 12 dose groups including 2,187 patients comparing BRV (1212 patients) to placebo (975 patients) are pooled in the present analysis. Subgroup, sensitivity and meta-regression analysis are also performed.

Results: The pooled RD in favour of BRV over placebo for ≥50% seizure frequency reduction was 13% and 3% for complete seizure freedom. The pooled RD for the proportion of patients withdrawn, withdrawn due to adverse events (AEs) and experienced with AEs was in favour of placebo over BRV 3%, 1% and 5%, respectively. Meta-regression analysis was demonstrated no significant linear relationship to dose, but significant linear relationship to treatment duration.

Conclusion: Meta-analysis provides evidence supporting BRV effectiveness as an add-on treatment for drug-resistant epilepsy. However, results may not be generalizable due to the pooled trials were of relatively short duration, small sample size, heterogeneity and provide no evidence for the long-term efficacy of BRV.